Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today. I do apologize that your question was not answered before. Different experts come online at various times; I just came online, read about your situation, and wanted to help.

Again I do apologize that my colleagues could not aid you sooner, but can you tell me:

How old is the cow?

By "fluid on her chest," do you mean in her lungs causing breathing issues (ie coughing, sneezing, wheezing, elevated breathing rates, etc)?

Or do you mean that you are seeing fluid pooling under her skin in the brisket region?

Are her gums pink or pale/white?

If you mean her lungs, have you seen any coughing, nasal discharge, or sneezing?If any discharges, what color?

If you mean fluid under her skin (edema), can you tell me what her scours was like (any blood or mucus)?

Now I am still keen for you to check her gum color when you can, since this would tell us if we just have a protein issue (which I will cover now) or if this is a dual protein/blood loss based issue. If you find her gums are pink, this won’t be as much a worry but if her gums are pale/white, then we’d also have to consider sources of blood loss and with it blood protein loss. Common causes of that would be trauma, GI bleeding, internal bleeding, barber pole worm, etc. Still in the meantime since this doesn’t sound overly suspicious of a blood loss situation, I will now outline our main concerns for the fluid under her skin at the chest (aka brisket edema).

Now to start, the fluid build up under the skin at the level of the chest (aka brisket edema) is actually a sign that we see when an animal having a low blood protein content (low blood proteins cause fluid in the vessels to leak into the tissues causing these fluid pockets). This is a condition referred to as hypoproteinemia. The most common cause for this is going to be parasitic disease (like GI worms). That said, this is not the only reason we can see either of these signs. Other common causes are scouring (severe or long term), live disease or damage (often by fluke or exposure to plants like St. Johns Wort or ragwort), kidney dysfunction, and heart issues.

Now since she had scours last week, this is very much a concern here. While it sounds like this wasn’t long term, if very severe then this is the likely trigger that pushed her into hypoproteinemia. That said, with its short duration, we do have to be concerned about something potentially putting her on the brink of a low protein issue prior to the scouring. Still at this stage, with these GI signs, I do want to note that we do have to consider a plethora of agents including bacterial (ie Salmonella, E.coli (Colibacillosis), C. Enterotoxemia. (Clostridium perfringens), Johnes etc.) viral (BVDV, Coronavirus, etc) parasitic (ie wormer resistant worms, liver fluke, PGE, protozoal agents, etc.), nutritional, and toxic causes (hopefully these last 2 are less likely here).

With all that in mind, as long as the scours has passed, we don’t have to panic about treating that. Still we do need to ensure we pinpoint and address any cause of low blood protein. This is because there are no simple treatments to increase blood protein that you can administer. For severe cases, we do give IV artificial proteins or blood products (ie plasma) to cows; but otherwise the key is to keep them eating (so they have the resources to make new proteins themselves) and clearing any of the above causes that would prevent her from normalizing that protein level and settling this herself.

Therefore, even if you have wormed her back in November, it would be ideal to consider testing a fecal sample now. A full fecal analysis would be ideal as it would rule out the above as well as determine if we have any wormer resistant fluke or worms present that need to be addressed. That said, if you are keen and have a microscope, you can find a really good guide for looking at fecal samples for parasites HERE . If any parasites are identified, then we’d want to treat to address these so that she doesn’t continue to lose protein and thus worsen her current state. And if you do send a sample to the lab and find one of the other above infectious agents, those would of course would need to be addressed as well.

Otherwise since we do have some organ issues (kidney, liver, heart) that could be to blame, if you were to address those infectious agents and she didn’t settle, then it’d be ideal to have her vet out. They can assess her heart on their physical examination and check liver/kidney function via blood sample. Now if these issues are found to be her trigger, there would be some potential treatment options (depending on severity and cause), but generally speaking these would have a guarded prognosis for a cow. So, hopefully she’d not have any of these issues.

Finally, while you have not noted if she is dehydrated, this is something that you do want to keep an eye on if she did have severe scours. If she is showing any signs of dehydration (skin tent, sticky mucus membranes, sunken eyes), then you may want to start instituting fluid therapy. For mild dehydration, oral drenching with an electrolyte solution may be an option. But if her diarrhea was severe or she is significantly dehydrated, then you do need to consider administration of sterile fluids via IV or at least subcutaneously (under the skin) to support her and address that dehydration.

Overall, there are a wide range of potential agents that could cause her low protein levels. If this cow is in with the rest of your herd, do consider separating her now to prevent any risk of spread (if she did have an issue like Johne’s). If she is dehydrated, then supportive care should be initiated now as well. As well, do consider having that fecal sample analyzed. It will shed light on what causative agent is plaguing this cow. And once the agent is identified, you will be able to address it effectively, halt the continued protein loss and give her body a chance to resorb this fluid and settle.

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